Disclosure of sexual orientation to health professionals in China: Results from an online cross-sectional study

Weiming Tang, Jessica Mao, Songyuan Tang, Chuncheng Liu, Katie Mollan, Bolin Cao, Terrence Wong, Ye Zhang, Michael Hudgens, Yilu Qin, Larry Han, Baoli Ma, Bin Yang, Wei Ma, Chongyi Wei, Joseph D. Tucker

Research output: Contribution to journalArticle

Abstract

Background: Many men who have sex with men (MSM) in China are "in the closet." The low rate of disclosure may impact sexual behaviours, testing for HIV and other sexually transmitted infections (STIs), and diseases transmission. This study examines factors associated with overall sexual orientation disclosure and disclosure to healthcare professionals. Methods: A nationwide cross-sectional online survey was conducted from September 2014 to October 2014 in China. Participants completed questions covering socio-demographic information, sexual behaviours, HIV/STI testing history, and self-reported HIV status. We defined healthcare professional disclosure as disclosing to a doctor or other medical provider. Results: A total of 1819 men started the survey and 1424 (78.3%) completed it. Among the 1424 participants, 62.2% (886/ 1424) reported overall disclosure, and 16.3% (232/1424) disclosed to healthcare professionals. In multivariate analyses, the odds of sexual orientation disclosure were 56% higher among MSM who used smartphone-based, sex-seeking applications [adjusted odds ratio (aOR) = 1.56, 95% CI: 1.25-2.95], but were lower among MSM reporting sex while drunk or recreational drug use. The odds of disclosure to a healthcare professional were greater among MSM who had ever tested for HIV or STIs (aOR = 3.36, 95% CI: 2.50-4.51 for HIV, and aOR = 4.92, 95% CI: 3.47-6.96 for STIs, respectively) or self-reported as living with HIV (aOR = 1.59, 95% CI: 0.93-2.72). Conclusion: Over 80% of MSM had not disclosed their sexual orientation to health professionals. This low level of disclosure likely represents a major obstacle to serving the unique needs of MSM in clinical settings. Further research and interventions to facilitate MSM sexual orientation disclosure, especially to health professionals, are urgently needed.

LanguageEnglish (US)
Article number21416
JournalJournal of the International AIDS Society
Volume20
Issue number1
DOIs
StatePublished - Feb 6 2017

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Disclosure
Sexual Behavior
China
Cross-Sectional Studies
Sexually Transmitted Diseases
Health
HIV
Odds Ratio
Delivery of Health Care
Infectious Disease Transmission
Street Drugs
Multivariate Analysis
History
Demography

Keywords

  • China
  • Disclosure
  • Healthcare professional
  • Men who have sex with men (MSM)
  • Sexual behaviours
  • Sexual orientation

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Disclosure of sexual orientation to health professionals in China : Results from an online cross-sectional study. / Tang, Weiming; Mao, Jessica; Tang, Songyuan; Liu, Chuncheng; Mollan, Katie; Cao, Bolin; Wong, Terrence; Zhang, Ye; Hudgens, Michael; Qin, Yilu; Han, Larry; Ma, Baoli; Yang, Bin; Ma, Wei; Wei, Chongyi; Tucker, Joseph D.

In: Journal of the International AIDS Society, Vol. 20, No. 1, 21416, 06.02.2017.

Research output: Contribution to journalArticle

Tang, W, Mao, J, Tang, S, Liu, C, Mollan, K, Cao, B, Wong, T, Zhang, Y, Hudgens, M, Qin, Y, Han, L, Ma, B, Yang, B, Ma, W, Wei, C & Tucker, JD 2017, 'Disclosure of sexual orientation to health professionals in China: Results from an online cross-sectional study' Journal of the International AIDS Society, vol 20, no. 1, 21416. DOI: 10.7448/IAS.20.1.21416
Tang, Weiming ; Mao, Jessica ; Tang, Songyuan ; Liu, Chuncheng ; Mollan, Katie ; Cao, Bolin ; Wong, Terrence ; Zhang, Ye ; Hudgens, Michael ; Qin, Yilu ; Han, Larry ; Ma, Baoli ; Yang, Bin ; Ma, Wei ; Wei, Chongyi ; Tucker, Joseph D./ Disclosure of sexual orientation to health professionals in China : Results from an online cross-sectional study. In: Journal of the International AIDS Society. 2017 ; Vol. 20, No. 1.
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abstract = "Background: Many men who have sex with men (MSM) in China are {"}in the closet.{"} The low rate of disclosure may impact sexual behaviours, testing for HIV and other sexually transmitted infections (STIs), and diseases transmission. This study examines factors associated with overall sexual orientation disclosure and disclosure to healthcare professionals. Methods: A nationwide cross-sectional online survey was conducted from September 2014 to October 2014 in China. Participants completed questions covering socio-demographic information, sexual behaviours, HIV/STI testing history, and self-reported HIV status. We defined healthcare professional disclosure as disclosing to a doctor or other medical provider. Results: A total of 1819 men started the survey and 1424 (78.3\{%}) completed it. Among the 1424 participants, 62.2\{%} (886/ 1424) reported overall disclosure, and 16.3\{%} (232/1424) disclosed to healthcare professionals. In multivariate analyses, the odds of sexual orientation disclosure were 56\{%} higher among MSM who used smartphone-based, sex-seeking applications [adjusted odds ratio (aOR) = 1.56, 95\{%} CI: 1.25-2.95], but were lower among MSM reporting sex while drunk or recreational drug use. The odds of disclosure to a healthcare professional were greater among MSM who had ever tested for HIV or STIs (aOR = 3.36, 95\{%} CI: 2.50-4.51 for HIV, and aOR = 4.92, 95\{%} CI: 3.47-6.96 for STIs, respectively) or self-reported as living with HIV (aOR = 1.59, 95\{%} CI: 0.93-2.72). Conclusion: Over 80\{%} of MSM had not disclosed their sexual orientation to health professionals. This low level of disclosure likely represents a major obstacle to serving the unique needs of MSM in clinical settings. Further research and interventions to facilitate MSM sexual orientation disclosure, especially to health professionals, are urgently needed.",
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author = "Weiming Tang and Jessica Mao and Songyuan Tang and Chuncheng Liu and Katie Mollan and Bolin Cao and Terrence Wong and Ye Zhang and Michael Hudgens and Yilu Qin and Larry Han and Baoli Ma and Bin Yang and Wei Ma and Chongyi Wei and Tucker, {Joseph D.}",
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AU - Mollan,Katie

AU - Cao,Bolin

AU - Wong,Terrence

AU - Zhang,Ye

AU - Hudgens,Michael

AU - Qin,Yilu

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N2 - Background: Many men who have sex with men (MSM) in China are "in the closet." The low rate of disclosure may impact sexual behaviours, testing for HIV and other sexually transmitted infections (STIs), and diseases transmission. This study examines factors associated with overall sexual orientation disclosure and disclosure to healthcare professionals. Methods: A nationwide cross-sectional online survey was conducted from September 2014 to October 2014 in China. Participants completed questions covering socio-demographic information, sexual behaviours, HIV/STI testing history, and self-reported HIV status. We defined healthcare professional disclosure as disclosing to a doctor or other medical provider. Results: A total of 1819 men started the survey and 1424 (78.3%) completed it. Among the 1424 participants, 62.2% (886/ 1424) reported overall disclosure, and 16.3% (232/1424) disclosed to healthcare professionals. In multivariate analyses, the odds of sexual orientation disclosure were 56% higher among MSM who used smartphone-based, sex-seeking applications [adjusted odds ratio (aOR) = 1.56, 95% CI: 1.25-2.95], but were lower among MSM reporting sex while drunk or recreational drug use. The odds of disclosure to a healthcare professional were greater among MSM who had ever tested for HIV or STIs (aOR = 3.36, 95% CI: 2.50-4.51 for HIV, and aOR = 4.92, 95% CI: 3.47-6.96 for STIs, respectively) or self-reported as living with HIV (aOR = 1.59, 95% CI: 0.93-2.72). Conclusion: Over 80% of MSM had not disclosed their sexual orientation to health professionals. This low level of disclosure likely represents a major obstacle to serving the unique needs of MSM in clinical settings. Further research and interventions to facilitate MSM sexual orientation disclosure, especially to health professionals, are urgently needed.

AB - Background: Many men who have sex with men (MSM) in China are "in the closet." The low rate of disclosure may impact sexual behaviours, testing for HIV and other sexually transmitted infections (STIs), and diseases transmission. This study examines factors associated with overall sexual orientation disclosure and disclosure to healthcare professionals. Methods: A nationwide cross-sectional online survey was conducted from September 2014 to October 2014 in China. Participants completed questions covering socio-demographic information, sexual behaviours, HIV/STI testing history, and self-reported HIV status. We defined healthcare professional disclosure as disclosing to a doctor or other medical provider. Results: A total of 1819 men started the survey and 1424 (78.3%) completed it. Among the 1424 participants, 62.2% (886/ 1424) reported overall disclosure, and 16.3% (232/1424) disclosed to healthcare professionals. In multivariate analyses, the odds of sexual orientation disclosure were 56% higher among MSM who used smartphone-based, sex-seeking applications [adjusted odds ratio (aOR) = 1.56, 95% CI: 1.25-2.95], but were lower among MSM reporting sex while drunk or recreational drug use. The odds of disclosure to a healthcare professional were greater among MSM who had ever tested for HIV or STIs (aOR = 3.36, 95% CI: 2.50-4.51 for HIV, and aOR = 4.92, 95% CI: 3.47-6.96 for STIs, respectively) or self-reported as living with HIV (aOR = 1.59, 95% CI: 0.93-2.72). Conclusion: Over 80% of MSM had not disclosed their sexual orientation to health professionals. This low level of disclosure likely represents a major obstacle to serving the unique needs of MSM in clinical settings. Further research and interventions to facilitate MSM sexual orientation disclosure, especially to health professionals, are urgently needed.

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